Since the start of the protocol, we have enrolled nearly 40 survivors of childhood cancer. In collaboration with the Children's National Medical Center Center for Cancer and Blood Disorders of Northern Virginia in Fairfax, I have been providing endocrine care through the bi-monthly multidisciplinary late effects clinic for childhood cancer survivors. This also allows our fellows and rotating medical students an opportunity to learn how to best manage these patients. We continue to collect data on each patient through our secure electronic database regarding their cancer treatment record; all participants are invited to complete a child health questionnaire evaluating quality of life. Each patient undergoes an individualized screening and counseling program, with careful review of the following endocrine systems: growth, pituitary and hypothalamic function, thyroid function, ovary and testicular function, bone health, risk of obesity, insulin resistance, and metabolic syndrome. We are studying novel markers to assess ovarian function in women with a history of exposure to alkylating agents or radiation. In addition, out of this project, a number of collaborative studies have arisen related to patients with active malignancies and their endocrine abnormalities. In February 2011, in collaboration with the NHLBI, we extended the age of eligible cancer survivors and allowed participants who are survivors of hematopoietic stem cell transplants, regardless of whether they had a primary malignancy. In July of 2011, we added carotid MRI intima-media thickness measurements to screen for early evidence of athlerosclerotic plaque in HSCT survivors and survivors of pediatric malignancies.